Thank you. I did my first session yesterday and it helped - even though i've done cbt before some of the ideas in that session material gave me a fresh perspective on things. I have a little time off work and am trying to get to see psychiatrist - hopefully I can get the medication I need, accept that and get working on healing...

Reggiecat, Welcome to our support community and thank you for sharing a little bit about yourself. As you can see our members are full of great support and advice. We encourage you to start working through the weekly sessions. There are some really great tools in there to help answer some of your questions. Depression is very individualized, no two people react the same to treatment or medication. Your experiences will be very different from others. You have posed some very good questions in your post. Depression is very personal, no two people react the same to treatment or medication. Your experiences will be very different from others. We encourage you to write these down and paper and talk to your doctor about them. Brenna, Bilingual Health Educator

"it seems that many people are on them for life - maybe their brains do get used to them so that it's so hard to come off. drug companies are commercial enterprises after all. " Reggiecat, remember depression is an illness, not an infection. A diabetic will have several precriptions for different insulins. An asmathic will have different inhalers for different attacks and maintainance... We have to learn new was of thinking. We have to learn to recognise our moods and adapt the situation to them.

wildcat, thanks to you too for the helpful response. I do have high expectations generally about a life - an idealist i guess. and they get higher and more unrealistic when i get depressed. 'why can't i be as talented as my favourite musician', 'they're really happy, i'm pathetic', why can't i just go back in time'.etc. when people i know care about me and say i've got a alot going for me - i forget this. I need to do lots of work on this once i stabilise again. But I still partly stuggle with the idea of taking the meds: 'why should i need these when my friends don't' 'how will i know *i* have changed if the meds have made me better - who am *i*', 'i'm weak for needing these', 'these aren't natural' 'i'm gonna be on them for life', 'they're going to change my brain chemistry so i always need them' of course this is in part depressed thinking... Like you first did, I did expect to have to take them for a year or so and then I'd be OK again. I did feel more stable and the doc was happy for me to come off. That's why coming off the Cymbalta to feel so awful again has been so hard to bear. it's not surprsing I suppose as though I've made some progress through CBT etc I'm still not happy with my job/relationships/home environment- still stuck in the same rut, plus guess my brain is still damaged. i should have researched it more before coming off, but you have to try and live and learn.. It's almost like I want to understand how something works before I'll let it work. I'm trying to be an amateur psychiatrist/psychotherapist about myself when extremely negative - pretty dangerous i think but i can't control it. It is good to be informed and to take control of the depression but often this is not what i'm doing... I like your explanation about the way the meds slows down the thoughts so you can recognise the patterns and learn to change - they get so out of control and go all over the place. positive thoughts always get drowned out... also that the meds are not just plugging a gap that will start leaking once you take them out (?) - i still have concerns about this. it seems that many people are on them for life - maybe their brains do get used to them so that it's so hard to come off. drug companies are commercial enterprises after all. But I'll try to worry about that later. This whole epidose was triggered by a year of intensive studying with major major stress combined with difficult new home environment, followed by falling apart and lots of ongoing big stuff going wrong/major disappointments. So it's no wonder my brain is damaged and I am hurting.. I guess a lot of people on here have been through similar dilemmas. It's good to share them though. Keep learning and growing despite the senselessness of it all at times :)

Daily llama, thanks for the response, it really helps. I guess it's hard to say what's working when the doses of meds are going up or down and the brain is acclimatising, especially when it's winter, the huge stress of a 10 hour flight/eing in foreign country without the usual support network etc + overanalysing it all and trying to fight them (?). But certainly so far it's fair to say they're not working too well and may be aggravating me? I'm going to see a psychiatrist rather than a General Practitioner finally - I wish I'd done it earlier but at least I'm doing it now.. I just want find the right one even if I doubt it's out there. I have to accept I'm going to be on them for a decent while so it needs to be helping me and not giving me bad side effects. That's got to be reasonable to expect? I'll talk to the psych about Effeoxr, the doc did mention it as a possibility. I don't think my depressed symptoms are totally typical - I sleep well, have a good appetite, look healthy to the casual observer, just have a raging storm inside from the moment i wake up - maybe not everyone has had the drug for them manufactured yet?? If only there was a test for levels of serotonin etc - this medication trial and error is nasty - especially when it's not a controlled experiment with what's going on in your life always changing. The scientist in me gets frustrated!! The sexual side effects really really bug me - I need to work on this as there's undoubtedly a major psychological element here (my friends tell me this) - huge anxiety about sex drive doesn't help sex drive! It's ironic as I split from my partner in part because i wanted to see what else was out there but now am so far from feeling confident in enjoying what else is out there even though I'm a nice, decent looking guy etc Perhaps back to the devil I know of Cymbalta + working on psychology + somehow finding an understanding woman is the best bet. Similarly once i stop being so anxious and negative my system and me will be able to do the occaisonal few drinks - I was able to do that when stable on Cymbalta. I agree that a good therapist is required. CBT helps in managing things but I think I need to go deeper into some of those core beliefs and buried stuff, that despite my constant self analysis I don't properly realise are there so i can let go of stuff and start to change the self destructive and overanalytical way I think. Hopefully the psychiatrist will recommend someone. An expensive business but what can you do eh? Have to accept this is my life now....

reggiecat, this is really long ... sorry :confuse:

reggiecat, what have been your expectations up till now? When I had my first major depressive episode I wanted to take my prozac for 2 weeks and come out knowing that i was equal to the other 2 billions people on the earth and feel happy. didn't happen and it was a real disappointment for me at 21. I had a few ups and downs and crashed when I had my miscarrage. i saw a soc-worker/art therapist and was hoping to learn some way of getting rid of the pain that seemed to be behind everything in my life. I was still missing something. So when I crashed and burned in nov 2005 I asked for a lot of details. What could I expect? What does this pill do do me in a day? in a week? in a month? How long will this pill last in my body before I need more (half-life)? What does it do for the brain, mind, and body...? So I have been on effexor XR for a while. and I have seen three psychiatrists one psychologist and several soc-workers for emerencies. Ah yes, and one self-help/support group. so what is effexor? it is a potent inhibitors of neuronal serotonin and norepinephrine reuptake and weak inhibitors of dopamine reuptake (SNRI). So it works on the same chemical as many other anti-depressants. It is 92% absorbed and 45% bioavailable - on average and it is the liver that metabolises it. So the body makes good use of each dose of the medication and you need a healthy liver to get rid of it at a reasonable rate. It has been approved for Depression, Generalized anxiety disorder and social anxiety disorder. You can easily look up the results for the clinical trials ... but in general 12 weeks of the medication at doses of of average 136mg and give a better score on the HAM-D total score, HAM-D Depressed Mood Item, the MADRS total score, the Clinical Global Impressions (CGI) Severity of Illness item, and the CGI Global Improvement item... all psychiatric diagnostic tools... [b]ONE[/b] dose of alcohol does not affect the drug's effectiveness etc (you can get all these details from the pharmacologists references now available on the net). I took the medication when I ended up at the doctor's office crying about not being able to travel, work nor put two thoughts together. I happily just swallowed the pills and hoped the next morning I would be better or DEAD. It way when I was stable; some 6 months later that I questioned the meds. I questioned the docs and the psych. It was then I wanted to know ... why did I need the meds and when could I get rid of them. Well the meds slow down things in my head. As an "inhibitors" the cells that spit out chemicals to communicate with other cells the meds slow down the process, so I can put two thoughts together. The meds slow down the thoughts so I can understand that I am making errors on my sequences of logic. Also, the meds slow down many of the thoughts that are linked together and provoke anxiety in me so I can "turn-off" certain ways of thinking. I needed to know how the body used the medication and what to expect from it now that I was begining to heal. And I learned REALLY quickly what a half-life meant in real terms... in high-school chemistry it was just another definition. With Effexor, it meant that 36 hours (one missed pill) and I was sick like a vegan with a burger. I needed to know what to expect and that was where i learned what a clinical trial could mean... and all those psych tools. To me it meant the effexor would take the edge off all the hurt I had. It meant that all the negatives would be just a bit more quiet so that I would have the time to heal and eventually LEARN what it means to feel normal. I saw that this medication let me have parts of my life back. I could eat what I was used to and I could get back into my routeens. It meant that I could drink a tanker truck of soft-drinks and a beer at the family bbq in the summer. It let me have a glass of wine at christmas... I do the alcohol thing in great moderation because I have

Hi Reggiecat and welcome, Anything i say here is highly suspect and should not be taken as anything other than a lay person's opinion and a very untutored one at that... I can't tell you about medications really as I've been on Prozac since it was released in Canada in the late '80s... I switched to Effexor for about a year to get some energy back from the Norepinephrine Reuptake Inhibitor component of it but then my blood pressure got bent out of shape so my doctor put me back on good old Prozac. It took 6 weeks to kick in the first time and no time at all the second time (well, the Effexor is an SSRI also...) I was very grateful for the calming effect the talk therapy had on me for the first 6 months on Prozac - but that all ended with a crash when I fell in lust with Mrs Psychiatrist and she with me... such is the weirdness of life blah blah blah... So, I hope you find a good talk therapist and that the Remeron with it's increase-action on the neurotransmitters of Serotonin and Norepinephrine settle you down a bit so you can look at your depression with less anxious eyes. I assume you're taking it last thing at night as it has a strongish soporific component. I think that once you've worked the CBT programme here for a while you'll feel more uppish and that will spark a better response from your flattened libido... it's weird but the Prozac alone kept me interested in sex and now that I'm taking Trazadone to sleep I discover that it also has an enhancing effect on the libido... who knew? But everybody's brain chemistry is different and I say all of the above just to tell you about my experience with meds... this may only be true for me alone... As for your questions: 1. six weeks for my Prozac - SSRI to kick-in( yours is a tetracyclic not an SSRI but acts on the same neurotransmitters as an SSRI) 2. With more serotonin and norepinephrine in your system from your med you might well be a new and improved version of your "self"??!! Dunno. 3.I accepted all the side affects from Prozac except I was on the lookout for big nausea, fainting and anything that was worse than how I felt being depressed and a lush ... never happened...plus I stopped drinking to excess and then pretty well stopped altogether... Like I said, I enjoyed orgasm better on Prozac - being more relaxed I guess 4. See above 5. Never know until you try it... maybe your doctor could tell you what s/he thinks about you taking Effexor... nothing to do with dopamine I think but does add to the energy factor (norepinephrine) - as for Dopamine, unless you have Parkinson's you'll not benefit from a dopamine agonist!! keep talking to us here... the other members will have many things to tell you about their experiences with the drugs you have cited in your post....

Hello there, my first post on here. Been suffering with major 'depression' for 3 years, I'm finally seeing a psychiatrist as an emergency someday soon as I've been pretty damn suicidal and hopeless :( -though better for reading this forum :) I feel dark dark anxiety, confusion about what's real, thoughts and theories going round in crazy ways to twist everything to attack myself and find contradictions, but appear OK/rational to people (and to the part of me that says nothing's wrong!) and holding down a job just. Done CBT, changing my environment and still considering quitting job/where I live, homeopathy(?), psychotherapy (terrible therapist!) therapy, yoga, eating well, exercising in moderation, stoppping alcohol and caffeine - they started messing me up even in small amounts once I stopped my meds. They mostly help but I'm trying to fully accept (part of me still doubts it) that medication is needed in righting the brain. This is because the jury's still out: I've been taking Mirtazapine for over 4 weeks now, 15mg for 2 weeks and then 30mg. 3 weeks in, I went on holiday for some winter sun as i hoped the meds would kick in - they hadn't done much till then, the odd better day, but some pretty nasty ones especially after increasing the dose. Seriously considered suicide on New Year's Eve... Big error - trapped in foreign country, suicidal. Luckily had a friend with me. I got referred to psychiatrist out there. I've come home early - what an expensive mistake!!! She gave me Lactimal and Seroquel at low doses to stabilise me and the mirtazapine. maybe as a stopgap? felt some postive effect first couple days, now back to usual. at least i'm home with more support even if the weather's terrible.... This is my third anti-depressant. I gave Citalopram 4 months with no real difference, even on a higher dose. I was then put on 60mg Cymbalta. I took it for about 10 months. i started to stabilise and had periods of feeling 'normal' after a while, though i *thought* mainly due to lifestyle changes. The loss of libido really worried me - the depression tied in with a long term relationship ending and I couldn't see how i would get another partner and try to move on - major pscyhological issues there. So I stopped it over 5 months, I thought i'd made it through nasty periods each time I lowered it, only to have a couple of months trying to tough it out, manage with dark darkness, feelings of failure (going through all that only to be kicked in the teeth at the end!) and crippling indecision before I finally bit the bullet and went on Mirtazapine - doc suggested as better for side effects. I know I shouldn't see this as failure but I do.. So, i suppose what i want to ask people is: 1. how long do you give the meds to work? I think I've been patient? 2. What is working? Maybe the Cymbalta was the best I could expect? I do expect a lot I guess - a real perfectionist streak that gets twistedly out of hand when depressed..but surely i should expect one that allows me to be me? whatever that is??? 3. What side effects do you accept and how do you deal with them? If I do have to take them for a couple more years or even life I can't cope with the sexual dysfunction.. I just hope I can find a med that works that doesn't hit too hard there. Shame mirtazapine ain't working as supposed to be better on that one. 4. I realise my brain is damged and needs to be treated well, but I'd like to go for a few drinks with friends now and again or dancing or hopefully on dates etc. without it messing me up big style afterwards. Will this ever happen again? It's just another way my life feels different and a pale imitation of what it used to be... 5. I've got a feeling (though could be bull****) that dopamine could be the answer, but scared of venlafaxine/effexor - seems like it's one for life. anyone got an